Provider Demographics
NPI:1013197813
Name:FOSTER, DIONNDRA GAYE (MED, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:DIONNDRA
Middle Name:GAYE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MED, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 PAZA DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-5107
Mailing Address - Country:US
Mailing Address - Phone:972-288-6489
Mailing Address - Fax:
Practice Address - Street 1:434 PAZA DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-5107
Practice Address - Country:US
Practice Address - Phone:972-288-6489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18522235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist